To become a psychiatrist in the US, you'll earn a bachelor's degree, complete 4 years of medical school for an M.D. or D.O., then finish a residency in psychiatry and get a state medical license. Psychiatrists are medical doctors, which is why they can diagnose mental illness and prescribe medication as well as provide therapy.
That medical training is the big difference from a psychologist or therapist, and it's why the path is long. But it also brings one of the stronger job outlooks among physician specialties.
Figures come from the Bureau of Labor Statistics (BLS) Occupational Outlook Handbook for physicians and surgeons, read on 26 October 2026.
Psychiatrists in numbers
| Measure | BLS figure |
|---|---|
| Median pay, psychiatrists (May 2025) | $281,870 a year |
| Median pay, all physicians and surgeons | $275,930 a year |
| Psychiatrist jobs, 2025 | 30,000 |
| Projected psychiatrist jobs, 2035 | 32,100 |
| Projected growth 2025 to 2035 | 7%, compared with 4% for all physicians |
Those figures are as of October 2026. BLS says growing demand for psychiatric care and improved access to mental health services will support job growth for psychiatrists.
What psychiatrists do
BLS describes psychiatrists as primary mental health physicians. They diagnose and treat mental illnesses through a combination of personal counseling (psychotherapy), psychoanalysis, hospitalization and medication. Psychotherapy involves helping clients change behavioral patterns and explore past experiences, while psychoanalysis means long-term psychotherapy and counseling. Psychiatrists may also prescribe medication to treat some mental illnesses.
How to become a psychiatrist, step by step
- Earn a bachelor's degree. No particular major is required, but medical school applicants usually study subjects such as biology, physical science or healthcare.
- Take the MCAT and apply to medical school. Schools are highly competitive and look at transcripts, MCAT scores, recommendation letters, leadership and extracurricular activities. Most interview applicants.
- Complete medical school. It takes 4 years: classroom study in anatomy, biochemistry, pharmacology, psychology and medical ethics, then clinical rotations in hospitals and clinics.
- Match into a psychiatry residency. Almost all graduates enter a residency in their chosen specialty. BLS says residencies last 3 to 9 years depending on the specialty.
- Get your state medical license. All states require physicians to be licensed, which includes passing standardized national exams.
- Consider board certification and a fellowship. Certification isn't required, but it may improve job prospects. Subspecialties, such as child and adolescent psychiatry, add a fellowship of 1 to 3 years.
Medical school in two phases
BLS describes medical school in two parts. In the first, you study in classrooms, small groups and laboratories, taking anatomy, biochemistry, pharmacology, psychology, medical ethics and the laws governing medicine, and you learn to take medical histories, examine patients and diagnose illnesses. In the second, you work with patients under supervision in hospitals and clinics through clerkships, or rotations, in areas such as internal medicine, pediatrics and surgery. Those rotations are often where future psychiatrists confirm the specialty is right for them.
BLS expects about 22,100 openings a year for physicians and surgeons overall, many of them from doctors retiring or leaving the field.
Psychology classes count for more than you'd think
Here's a point many pre-med students overlook. BLS lists psychology among the courses students take in the first phase of medical school, alongside anatomy and pharmacology. If psychiatry is your goal, an undergraduate background in psychology or a related field can sit comfortably alongside the science prerequisites medical schools expect, and it shows admissions committees where your interest lies.
Some medical schools also offer combined undergraduate and medical programs lasting 6 to 8 years, and combined graduate degrees such as M.D.-Ph.D. or M.D.-MPH, which can suit people interested in research or public mental health.
Psychiatrist, psychologist or therapist?
| Role | Training | Can prescribe medication? |
|---|---|---|
| Psychiatrist | Medical school (M.D. or D.O.) plus residency | Yes |
| Psychologist | Graduate degree in psychology (doctorate for clinical work) | Only in some states, for clinical psychologists |
| Therapist or counselor | Master's degree plus supervised hours | Not part of the role |
If you're not sure which suits you, our guides to AI tools for therapists and prompts for therapists give a feel for the day-to-day side of mental health practice.
What the work is like
Most physicians work full time, and some work more than 40 hours a week. Many work long shifts, which may include irregular and overnight hours or being on call. Physicians work in clinical settings, such as offices and hospitals, and in nonclinical settings such as government agencies and nonprofits. Some choose fields without patient care, such as research or public policy.
In group practices and healthcare organizations, physicians can coordinate care with other professionals, though BLS notes they have less independence than solo practitioners.
Want AI doing the heavy lifting in your marketing?
I build the systems that handle the boring 80 percent, so you get your week back. Done properly, with the human kept in.
My verdict
Psychiatry is a long road: a bachelor's degree, 4 years of medical school, then residency and licensing. The payoff is a specialty with a growth rate well above the physician average and a median of $281,870, as of October 2026. If you're certain you want to work in mental health and you're ready for medical school, it's a strong choice. If medical school isn't for you, psychology or counseling reach many of the same patients by a shorter route.
Frequently asked questions
How long does it take to become a psychiatrist?
A bachelor's degree, 4 years of medical school, then a residency. BLS says residencies last 3 to 9 years depending on the specialty, plus 1 to 3 more years for a fellowship.
How much do psychiatrists make?
BLS reports a median of $281,870 a year for psychiatrists in May 2025.
Is psychiatry a growing field?
Yes. BLS projects psychiatrist jobs to grow 7% from 2025 to 2035, from 30,000 to 32,100.
What is the difference between a psychiatrist and a psychologist?
A psychiatrist is a physician who may prescribe medication. A psychologist has a graduate degree in psychology and works with clients through assessment and therapy; only some states let clinical psychologists prescribe.
What should I major in to become a psychiatrist?
No specific major is required. Medical school applicants usually study biology, physical science or healthcare, and psychology is also covered in medical school.
Do psychiatrists need board certification?
It isn't required, but BLS says board certification may increase employment opportunities.
Can psychiatrists do therapy?
Yes. BLS says psychiatrists treat mental illness through psychotherapy, psychoanalysis, hospitalization and medication.
What is an M.D. or D.O.?
The two medical degrees physicians earn: a Medical Doctor (M.D.) or a Doctor of Osteopathic Medicine (D.O.).
